Doctor Name: | JUILANN MARIE FORD |
NPI Number: | 1447395447 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., CCCSLP |
License Number: | 22001708A |
Business Practice Address: | 108 N Main St Suite 820 South Bend, IN - 466011625 |
Business Phone Number: | 5742347244 |
Business Fax Number: | 5742349663 |
Mailing Address: | 108 N Main St, Suite 820 SOUTH BEND |
State: | IN |
Postal Code: | 466011625 |
Phone Number: | 5742347244 |
Fax Number: | 5742349663 |
NPI Enumeration Date: | 02/20/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22001708A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |